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  1. <!doctype html>
  2. <html >
  3. <head>
  4. <title>Kostenerstattungsforumlar</title>
  5. <meta charset="utf-8">
  6. <meta name="viewport" content="width=device-width, initial-scale=1">
  7. <!-- Kube CSS -->
  8. <link rel="stylesheet" href="css/kube.min.css">
  9. <link rel="stylesheet" href="addons/kube-addons.min.css" />
  10. <link rel="stylesheet" href="master.css" />
  11. </head>
  12. <body>
  13. <div class="page is-container">
  14. <div class="main-sidebar">
  15. <img alt="wikimedia logo" src="wmde.png"/>
  16. </div>
  17. <div class="main-content">
  18. <h1>Auslagenersatz</h1>
  19. <p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines
  20. Projektes entstanden sind?<BR>
  21. Bitte fülle dieses Formular aus ...
  22. </p>
  23. <form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">
  24. <div class="is-row">
  25. <div class="is-col is-70">
  26. <fieldset>
  27. <legend>1. Erfasse deine Stammdaten</legend>
  28. <div class="is-row">
  29. <div class="is-col">
  30. <input required type="input"
  31. size="32" id="nickname" name="nickname"
  32. placeholder="Nickname*" />
  33. </div>
  34. <div class="is-col">
  35. <input required type="input"
  36. size="32" id="projectid" name="project"
  37. placeholder="Projekt-ID*" />
  38. </div>
  39. </div>
  40. <br>
  41. <div class="is-row">
  42. <div class="is-col">
  43. <input required type="input" size="32"
  44. ` id="realname" name="realname" placeholder="Dein Realname (Vorname Nachname)*" />
  45. </div>
  46. <div class="is-col">
  47. <input required type="input" size="32"
  48. ` id="wmdecontact" name="wmdecontact" placeholder="Deine Ansprechperson bei Wikimedia*" />
  49. </div>
  50. </div>
  51. <br>
  52. <div class="is-row">
  53. <div class="is-col">
  54. <input required type="tel" size="32"
  55. id="phone" name="phone"
  56. placeholder="Deine Telefonnummer" />
  57. </div>
  58. <div class="is-col">
  59. </div>
  60. </div>
  61. <br>
  62. <div class="is-row">
  63. <div class="is-col">
  64. <input required type="email" size="32" id="email"
  65. name="email" placeholder="Deine E-Mail-Adresse*" />
  66. </div>
  67. <div class="is-col">
  68. </div>
  69. </div>
  70. <br>
  71. <div class="is-row">
  72. <div class="is-col">
  73. <nav class="tabs" data-kube="tabs" data-equal="false">
  74. <a href="#bank-eu" class="is-active">Banküberweisung</a>
  75. <a href="#bank-noneu">Banküberweisung(Non-EU)</a>
  76. <a href="#bank-paypal">PayPal</a>
  77. <a href="#bank-bar">Barauszahlung</a>
  78. </nav>
  79. <section id="bank-eu">
  80. <div class="is-row">
  81. <div class="is-col">
  82. <input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />
  83. </div>
  84. <div class="is-col">
  85. </div>
  86. </div>
  87. <br>
  88. <div class="is-row">
  89. <div class="is-col">
  90. <input type="input" size="32" id="iban" name="iban" placeholder="IBAN*" />
  91. </div>
  92. <div class="is-col">
  93. <input type="input" size="32" id="bic" name="bic" placeholder="BIC*" />
  94. </div>
  95. </div>
  96. <br>
  97. <input type="input" size="32" id="purpose" name="purpose" placeholder="Verwendungszweck" />
  98. </section>
  99. <section id="bank-noneu">
  100. <div class="is-row">
  101. <div class="is-col">
  102. <input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />
  103. </div>
  104. <div class="is-col">
  105. </div>
  106. </div>
  107. <br>
  108. <div class="is-row">
  109. <div class="is-col">
  110. <input type="input" size="32" id="n_iban" name="n_iban" placeholder="Kontonummer*" />
  111. </div>
  112. <div class="is-col">
  113. <input type="input" size="32" id="n_bic" name="n_bic" placeholder="BIC/SWIFT*" />
  114. </div>
  115. </div>
  116. <br>
  117. <input class="EU nonEU" type="input" size="32" id="n_bank" name="n_bankname" placeholder="Name der Bank*" />
  118. <br>
  119. <textarea class="nonEU" name="n_bankaddress" id="n_bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Adresse der Bank (Strasse und Hausnummer/Postleitzahl/Land)"></textarea>
  120. <br>
  121. <textarea name="n_address" lang="de" class="nonEU" id="n_address" style="resize:both;" cols="32" rows="4" placeholder="Deine Anschrift (Srtasse und Hausnummer/Postleitzahl/Land)
  122. "></textarea>
  123. <br>
  124. <input type="input" size="32" id="n_purpose" name="n_purpose" placeholder="Verwendungszweck" />
  125. </section>
  126. <section id="bank-paypal">
  127. <input name="paypal" type="input" size="32"
  128. id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />
  129. </section>
  130. <section id="bank-bar">
  131. </section>
  132. </div> <!-- i-col -->
  133. </div> <!-- is-row -->
  134. </fieldset>
  135. </div>
  136. <div class="is-col ">
  137. <?php include "h1.php"; ?>
  138. </div>
  139. </div> <!-- is row -->
  140. <br>
  141. <div class="is-row">
  142. <div class="is-col is-70">
  143. <fieldset id="fieldset2">
  144. <legend>2. Erfasse deine Ausgaben</legend>
  145. <div class="is-row">
  146. <div class="is-col is-70">
  147. <div class="is-row">
  148. <div class="is-col is-60">
  149. <input id="a_type" type="text" name="type" placeholder="Auslagenart*"/>
  150. </div>
  151. <div class="is-col is-40">
  152. <input id="a_date" type="date" name="type" placeholder="Datum*"/>
  153. </div>
  154. </div>
  155. <br>
  156. <input id="a_description" type="text" name="description" placeholder="Beschreibung*"/>
  157. <br>
  158. <div class="is-row">
  159. <div class="is-col">
  160. <input id="a_amount" type="text" name="amount" placeholder="Betrag*"/>
  161. </div>
  162. <div class="is-col">
  163. <input id="a_currency" type="text" name="curreny" placeholder="Waehrung*"/>
  164. </div>
  165. <div class="is-col">
  166. <button type="button" onclick="addTableRow();"
  167. class="button is-green">Ausgabe hinzuf&uuml;gen</button>
  168. </div>
  169. </div>
  170. </div>
  171. <div class="is-col is-30">
  172. <div id="uploadfield" class="form-item">
  173. </div>
  174. </div>
  175. </div>
  176. <br>
  177. <table id="tabtab" class="is-bordered is-striped">
  178. <thead>
  179. <tr>
  180. <th>Auslagenart</th>
  181. <th>Datum</th>
  182. <th>Beschreibung</th>
  183. <th>Betrag</th>
  184. <th>W&auml;hrung</th>
  185. <th>L&ouml;schen</th>
  186. </tr>
  187. </thead>
  188. <tbody id="tabbody">
  189. </tbody>
  190. </table>
  191. </fieldset>
  192. </div>
  193. <div class="is-col">
  194. hilfe 2
  195. </div>
  196. </div>
  197. <button onclick="addTableRow();"
  198. class="button is-green">Antrag elektronisch versenden</button>
  199. <button type="button" onclick="downloadDocument();"
  200. class="button is-orange">Herunterladen</button>
  201. </div>
  202. </div>
  203. <input type="hidden" id="banktype" name="banktype"/>
  204. <!-- <input type="submit" style="display:none" name="submitButton" /> -->
  205. </form>
  206. <!-- Kube JS (optional if you are using Kube CSS only) -->
  207. <script src="js/kube.min.js"></script>
  208. <script src="addons/upload/kube.upload.min.js"></script>
  209. <script src="addons/kube-addons.min.js"></script>
  210. <script src="kaform.js"></script>
  211. <script src="iban.js/iban.js"></script>
  212. </div>
  213. </div>
  214. </body>
  215. </html>